"Hence fevers, attributed to contagion, make an equally rapid progress, where guards have been placed, and high walls have been built, as in Russia, &c. to prevent communication; and some instances have happened of a great part of Europe, Asia, Africa, and America, suffering from similar fevers nearly at the same time. The partial appearances of pestilential fevers, and the frequent occurrence at the same place, are proofs of some local diseased state of the earth, &c.

But our readers must be already disgusted with such a detail of absurdity, as never issued from the brain of one still retaining the direction of his own affairs. It would, therefore, be altogether superfluous to attempt a farther development of this "New System," if we could accomplish it from the loose hints scattered over the large pages, of which this book consists. This, indeed, is the less necessary, as the author, even in his preface, justly anticipitates its fate. "My medical opinions," he says, "are too far removed from common ideas, and common apprehensions, to be approved of by the multitude, or to confer any popularity on the author:" a sentence which, whatever the reader might conceive to the contrary, evinces that some degree of the faculty of perceiving truth still remains in the Doctor's "electrical apparatus. His perceptions of grammar and orthography, however, are not always quite so correct, especially in regard to the Latin; as when he says "a putrid effluvia,"-"the effluvia enters; " (p. 99.) "the stamina depends;" p. 66-when he tells us, that the urine is charged with phosphate of lime in cases of "Molitas ossis ; p. 53, and thus copies Dr Cullen's definition of exanthemata

Morbi contagiosa simel tantùm in decursu vitæ, &c.; definitio tempore apparent phlogosis," &c. p. 196.--Other similar blunders occur.

After having thus gone through the fundamental principles of the new system, this very original chemist, who has borrowed nothing from the doctrines of the French chemists, now in every student's mouth, proceeds to give new appellations to all the diseases in Dr Cullen's arrangement, (whose characters, however, he copies), and goes on in the old routine of remedies. But then his practice" is too far removed from common ideas" to be conducted upon the common motives. He will give misletoe to epileptic persons; but it is only upon the idea, that it " may communicate something to the system that may improve the electrical powers of the brain." (p. 73.) He will likewise prescribe the vcgetable bitters; but not as vulgar tonics or corroborants;--they are intended to " prevent decomposition, by increasing the cohesion of the body;" and he will talk learnedly and chemically, at the same time, about "the diffusibility of tannin."

In a word, the annals of empiricism contain not such a paltry example of pompous imposition and splendid nonsense, from the days of John of Gaddesden downwards, as is exhibited in this wire-wove imperial octavo.

VII.

Cases of Organic Diseases of the Heart, with Dissections, and some remarks, intended to point out the distinctive symptoms of these diseases: Read before the Counsellors of the Massachussets Medical Society. By JOHN E. WARREN, M. D. Boston, 1809. 8vo. pp. 61, and 2 plates.

THES HESE cases, ten in number, are sufficiently interesting; most happily illustrate the general observations of Corvisart, with which Dr Warren appears to have been previously acquainted; and prove how constantly the principal organic lesions of the heart are connected with the external phenomena which the French physician has shown to be diagnostic of these changes.

Of these cases, seven were examples of solid enlargement, and active ancurism of the heart; there is one case only of simple dilatation or passive aneurism. These eight cases were connected also with ossification, or induration of the valves. In the seventh case, the aorta and its valves were thickened, and the heart unaffected. In the eighth, along with rigidity of the tricuspid valves, and the pulmonary semilunars, the heart was found covered with fat, and enlarged, but whether solidly, or by simple dilatation, is not mentioned. To these cases is subjoined the following table.

Enumeration of the principal morbid changes observed in the organization of the heart, in the preceding cases. Enlargement of the volume of the heart, or aneurism. Increase of the capacity or aneurism of the right auricle

its.coats.

of the right ventricle

of the left auricle

of the left ventricle

with thick

ened or thin

Sparietes.

of the aorta, with thickening of

Cartilaginous thickening of the internal membrane of the heart, and generally of its valves.

Ossification of the parietes of the heart.

mitral valves.

aortal valves.

aorta.

coronary arteries.

Enumeration of the principal morbid appearances observed in these cases of disease of the heart, which may be considered secondary. In the cavity of the cranium.

Inflammation of the meninges.

Water between the meninges.

Water in the ventricles.

In the pleura, and its cavity.

Inflammation and thickening of the pleura.

Collection of water in its cavity.

Lungs dark coloured.

generally very firm, and particularly in some parts.
loaded with black blood.

crowded into a narrow space.

In the pericardium and its cavity.

Inflammation and thickening of its substance.
Adhesion to the heart and lungs.

Collection of water in its cavity.

In the cavity of the abdomen.

Collection of water.

Liver very full of fluid blood

having its tunic flaccid and inflamed.

Mesenteric veins full of blood.

Cellular membrane full of water.

The blood everywhere fluid, except in the cavities of the heart. In those cases which came under our author's notice, the symptoms most observable are the following

"The first notice of disorder is commonly from an irregular and tumultuous movement of the heart, which occurs before any perceptible derangement of the other functions. This irregularity slowly increases, and arrives at its height before the strength of the patient is much impaired, at least in the cases which I have noticed; and as the vigour of the patient lessens, the force of the palpitations dimi nishes. These palpitations are often so strong as to be perceptible to the eye at a considerable distance. They are seldom most distinct in the place where the pulsation of the heart is usually felt. Sometimes they are perceived a little below; often in the epigastric region; and not unfrequently beneath, and on the right side of the sternum. "After the palpitations have lasted some time, a little difficulty of

breathing, accompanied with sighing, is perceived, especially on any great exertion, ascending an eminence, or taking cold, of which there is an uncommon susceptibility. This dyspnoea becomes, as it increases, a most distressing symptom. It is induced by the slightest cause; as by an irregularity in diet, emotions of the mind, and especially movement of the body; so that, on ascending stairs quickly, the patient is threatened with immediate suffocation. It occurs at no stated periods, but is never long absent, nor abates much in violence during the course of the disease. It is attended with a sensation of universal distress, which perhaps may arise from the circulation of unoxygenated blood, or accumulation of carbon in the system; for the countenance becomes livid, and the skin, especially that of the extremities, receives a permanent dark colour. This dyspnoea soon causes distress in lying in an horizontal posture. The patient raises his head in bed gradually, adding one pillow after another, till he can rarely, in some cases never, lie down without danger of suffocation; he inclines his head and breast forward, and a bench placed before him. supports himself upon an attendant, or power is no longer capable of maintaining him in that posture, and A few hours before death, the muscular he sinks backward. The dyspnoea is attended with cough, sometimes through the whole of the disease, sometimes only at intervals. The cough varies in frequency. It is always attended with copious expectoration of thick mucus, which, as the disease advances, becomes brown-coloured, and often tinged with blood. death, it frequently consists entirely of black blood. A short time before

"The changes in the phenomena of the circulation are very remarkable. The sanguiferous system is increased in capacity; the veins, especially, are swelled with blood; the countenance is highcoloured, except in fits of dyspnoea, when it becomes livid; and it is very frequently puffed or turgid. The brightness of the eyes, dizziness, which is a common, and headach, which is a frequent symptom, and in some cases very distressing, are probably connected with these changes. The motions of the heart, as has already been stated, are inordinate, irregular, and tumultuous. The pulse presents many peculiarities; in some cases, probably, where there is no obstruction in the orifices of the heart, it remains tolerably regular, and is either hard, full, quick, vibrating, and variable, or soft, slow, compressible, and variable; most commonly, perhaps always, when the orifices of the heart are obstructed, it is vibrating, very regular, very intermittent, sometimes contracted, and almost imperceptible, very variable, often disagreeing with the pulsations of the heart, and sometimes differing in one of the wrists from the other.

The functions of the brain suffer much disturbance. Melancholy, and a disposition for reverie attend the early stages of the complaint; and there is sometimes an uncommon irritability of mind. The dreams become frightful, and are interrupted by sudden starting up in ter

ror.

Strange illusions present themselves. The mental faculties are impaired. The termination of the disease is attended with slight delirium, sometimes with frenzy, and with hemiplegia.

“The abdominal vifcera are locally, as well as generally affected. Although the digeftive functions are occafionally deranged, the appetite is at fome periods remarkably keen. The action of the inteftines is fometimes regular, but a state of coftiveness is common. The liver is often enlarged, probably from accumulation of blood. This diftenfion is attended with pain; varies much; and, in all the cafes I have feen, has fubfided before death, leaving the coats of the liver wrinkled, flaccid, and marked with appearances of inflammation, caused by the distension and preffure against the furrounding parts. An effect of the accumulation of blood in the liver, and consequently in the mesenteric veins, is the frequent difcharge of blood from the hemorrhoidal veffels. This occurs both in the early and late stages of the disease, and may become a formidable fymptom. Evacuations of blood from the nofe are not uncommon.

"Dropfical fwellings in various parts of the body fucceed the fymptoms already enumerated. They commence in the cellular membrane of the feet, and gradually extend up the legs and thighs; thence to the abdominal cavity; to the thorax; fometimes to the pericardium, to the face, and fuperior extremities; and, laftly, to the ventricles and meninges of the brain. These collections of water may be reabforbed by the aid of medicine; but they always return, and attend, in fome degree, the patient's death.

"There is no circumstance more remarkable in the courfe of this complaint, than the alternations of eafe and diftrefs. At one time, the patient fuffers the fevereft agonies; affumes the moft ghaftly appearance, and is apparently on the verge of death: in a day, or a week after, his pain leaves him; his happiness and cheerfulness return; a degree of vigour is reftored; and his friends forget that he has been ill. The pa roxyfms occafionally recur, and become more frequent, as the difeafe progreffes. Afterwards, the intermiffions are thorter; and a clofe fuc• ceffion of paroxysms begins. If the progrefs of the complaint has been flow and regular, the patient finks into a state of torpor, and dies without fuffering great diftrefs. If, on the contrary, its progrefs has been rapid, the dyspnoea becomes exceffive; the pain and stricture about the præcordia are infupportable; a furious delirium fometimes fucceeds; and the patient expires in terrible agony.

VIII.

A Commentary on the Treatment of Ruptures, particularly in a State of Strangulation. By EDWARD GEOHEGAN, Member of the Royal College of Surgeons, &c. London, 1810. Svo. pp. 95.

THE

THE object of this performance is to maintain, that the taxis, or attempt to reduce strangulated hernia by manual force and dexterity, is useless, dangerous, and should be abandoned.